The term "Estrogen Dominance" can be confusing at times because it is less related to the amount of circulating estrogen and more related to the ratio of estrogen to progesterone in the body. Contrary to popular belief, Menopause and PMS are not the result of estrogen deficiency although estrogen levels do decline during the latter phases of a woman reproductive cycle.
More relevant is that the estrogen levels drop by approximately 40% at menopause while progesterone levels plummet by approximately 90% from premenopausal levels. It is the relative loss of progesterone that causes the majority of symptoms termed estrogen dominance. The disproportionate loss of progesterone begins in the latter stages of a woman's reproductive cycle, when the luteal phase of the menstrual cycle begins to malfunction. The malfunction is initiated when the remnant tissue of the follicle (corpus luteum), the primary source of progesterone, begins to lose its functional capacity. By about age 35, many of these follicles fail to develop creating a relative progesterone deficiency. As a result, ovulation does not always occur and progesterone levels steadily decline. It is during this period that a relative progesterone deficiency, or what has become known as Estrogen Dominance, develops.
Typical symptoms of estrogen dominance are:
- Mood Swings
- Irritability
- Depression
- Irregular Periods
- Heavy Menstrual Bleeding
- Hot Flashes
- Vaginal Dryness
- Water Retention
- Weight Gain: Hips, Thighs and Abdomen
- Sleep Disturbance (Insomnia, less REM sleep)
- Decreased Libido
- Headaches
- Fatigue
- Short-term Memory Loss
- Lack of Concentration
- Dry, Thin, Wrinkly Skin
- Thinning of Scalp Hair
- Increased Facial Hair
- Bone Mineral Loss (Osteoporosis)
- Diffuse Aches and Pain
Patients experiencing a majority of these symptoms most likely will benefit from natural hormone replacement. The most effective way to assess hormone status is to test saliva for the appropriate hormone levels. Saliva is the best method for testing "functional" tissue levels of hormones.
The Progesterone/Estradiol (Pg/E2) reference ranges are optimal ranges determined by Dr. John Lee. While they are not physiological ranges, they are optimal values for the protection of the breasts, heart and bones in women, and the prostate in men. Salivary values within these ranges have been shown by Dr. Lee to decrease both breast and prostate cellular proliferation.


2 comments:
I have a24 y old female patient who has been on YAZ contraceprive opills for several years. Her menstrual history is characterized by 28 day cycle with premenstrual changes of mood,occasional breast sensitivity, occasional heavy flows.She reports periodic disputes with her boyfriend around that time. Feels very guilty how snappy she gets, questioning their relationship.She suffers anxiety and fear around that time as well.
I believe she has estrogen dominance .Could you comment .
Thank you.
I believe you are correct in your hunch about estrogen dominance. Because her BCP’s block ovulation from occurring, the corpus luteum is not producing progesterone and thus the effects of estrogens become even more pronounced. Remember that progesterone is our natural anti-anxiety hormone. Sometimes we will also see a decrease in testosterone as well, due to BCP’s. This will also diminish her overall sense of well-being and self-esteem. So the hormonal imbalances occurring may be multifaceted. Testing her salivary hormone levels will confirm your hunches and help you narrow in on appropriate treatments.
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